Intercept grabs the spotlight at EASL, builds case for lead drug OCA

Investigators for Intercept Pharmaceuticals spelled out the impact of its lead therapy on rare cases of a liver disease called primary biliary cirrhosis (PBC), fleshing out the results of a late-stage study that it will use to seek U.S. and European approvals later in the year.

Intercept ($ICPT) had already unveiled the key takeaway from Phase III: Its drug significantly reduced levels of alkaline phosphatase in close to half of all patients in two drug arms, compared to 10% of the patients taking a placebo. In a late breaker at a meeting of the European Association for the Study of the Liver (EASL), investigators added that the positive impact of the drug could be seen after two weeks in some patients, with peak efficacy at 6 months. Cases of pruritis--severe itching--were the chief concern in the study.

Intercept, based in New York with development activities in San Diego, has been positioning OCA as an important new therapy for a disease that has traditionally been treated with ursodiol. The older drug often works for the disease, a swelling of the biliary ducts that causes a backup of bile that threatens the liver, but executives for the biotech say that there's a big market waiting if they can get an approval for treating up to half of all patients who don't respond adequately to the mainstay drug.

Intercept CMO David Shapiro

"PBC has been a rather neglected disease, an orphan disease but not ultra rare, affecting 1 out of 1,000 women over the age of 40," David Shapiro, Intercept's chief medical officer, tells FierceBiotech. With up to half of those women achieving only a suboptimal response, "there's a need for a better therapy."

"This is a drug which is working in second line, which is the most difficult one," adds Frederik Nevens, the chief investigator in the study. Intercept has now tested this drug on more than 500 patients, he adds, in mid- and late-stage studies. And all the data point to its potential as a "highly effective" new treatment.

Shapiro also notes that there were no signs of cardiovascular side effects in the Phase III. Intercept had startled investors a few weeks ago with a 10-K filing noting some cardiovascular incidents among patients, but quickly managed to tamp down the fretting with the late-stage data.

The biotech believes OCA is a first-in-class agonist of the farnesoid X receptor with a broad ability to guard the liver. The NIH had been studying OCA for nonalcoholic steatohepatitis, or NASH, which bears all the signs of liver disease seen in alcoholics, but in people who don't drink. The disease is triggered by a diet high in fat and sugar, and it's been spreading around the world after growing into a serious health problem in the U.S. and Europe.

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